CASE STUDY ONE: Omar*, 13, from the Gaza Strip, has already led an exceptional life in spite of his young age.
Omar is the eldest child of a university professor and social care worker in the Gaza Strip. His parents tried to have children for a very long time until eventually receiving their happy miracle. As such, he is extremely precious to them. He grew up to be a very smart child, achieving mainly 90% or higher in all his school exams.
In late 2013, at the age of 10, Omar’s vision began to deteriorate. His mother recalled holding fingers out in front his face for him to count and him being unable to see anything. Consequently his grades began to plummet. His parents took him to the local government hospital in Gaza, which referred him on to a specialist clinic in Ramallah (in the West Bank). This is quite a difficult trip for any Gazan to make. It is not only expensive but there is also an arduous permit procedure to reach the West Bank. In December 2015 the permit approval for medical cases dropped to its lowest in seven years.
Thankfully, in this family’s case, they managed to arrange permits. Tests were undertaken, and the most devastating diagnosis was given to the family. Omar had a mass behind his right eye. It was diagnosed as an intraocular tumor, that might or might not be cancerous. Further checks would be necessary to see whether the tumor was malignant and his eye would potentially need to be removed. His mother described her utter devastation at receiving the news; after being given the miracle of her son, it felt as if he were being taken away.
However, thanks to the keen eye of one local Gazan doctor, and our St John team, Omar’s story did not end in tragedy. As Ramallah is hard to reach for local Gazans, his case was moved to the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) hospital in Gaza. It was there his case was handed to a local doctor who noted there was something not quite right about Omar’s diagnosis. He opted to get a second opinion from St John's own retinal expert, who has a reputation for being one of the best retinal eye doctors in the area. Omar first saw our doctor three agonizing months after his original diagnosis, and this is where his story changes for the better.
After further testing Omar was re-diagnosed not with an intraocular tumor, but with a congenital ruptured retinal macro aneurysm - a different condition entirely. This is essentially a vein behind the eye that is weak from birth. If it is over exerted the vein will burst, causing vision loss and permanent blindness if it is not caught in time. The mass which was originally diagnosed as a tumor was in fact an accumulation of blood from a burst vein. The family was given the good news and their relief was incredible.
However the treatment Omar would have to undergo was still difficult. Our doctor took great care to stress the fact that, in his words, Omar was a ‘hero’, for undergoing the treatment at such a young age. All in all over six months he received five laser eye treatments and six injections into his eye. All but one of these was performed under topical anesthesia. That means that Omar was fully conscious, with only eye drops to numb the eye. He is one of the only children treated at SJEHG who has been brave and patient enough for this method to even be an option. Most children are much too fidgety or scared to even consider local anesthesia. It is however the safer option overall.
Omar is now a happy and healthy 13 year old. His eyesight is so good he does not even need to wear glasses. He absolutely loves math, his favorite subject at school, and plans to train as a doctor. His grades are back up in the top percentile. The family are extremely thankful for the expert care that SJEHG had to offer.